Синдром короткой кишки у детей: терминология, современные аспекты патогенеза, новые подходы к диагностике и лечению (обзор литературы и собственный клинический опыт)
DOI:
https://doi.org/10.15574/SP.2015.67.78Аннотация
Синдром короткой кишки (СКК) устанавливается при потере значительной длины тонкой кишки и ее функциональной неполноценности. Основным клиническим проявлением СКК является выраженная мальабсорбция. Пациенты с СКК требуют длительной парентеральной поддержки вплоть до адаптации кишечника. Поэтому дети с СКК постоянно находятся под наблюдением врачей, с регулярным мониторингом общего состояния и лабораторных показателей с целью профилактики серьезных осложнений. Лечение СКК направлено на достижение адекватно о энтерального питания пациента.
Ключевые слова: синдром короткой кишки, дети, кишечная адаптация, лечение, нутритивная поддержка.
Библиографические ссылки
Atlas detskoy operativnoy hirurgii. Pod red P Puri, M Golvarta. M, MEDpress-inform. 2009: 273—291.
Krums LM, Sabelnikova EA. 2002. Sindrom korotkoy tonkoy kishki: aktualnyie problemyi patogeneza, kliniki i lecheniya. Eksperimen i klin gastroenterol. 6: 49—52.
Musselius YuS, Mihelson VA, Stepanenko SM. 2004. Nutritivnaya terapiya v perioperativnom periode. Anesteziol i reanimatol. 1: 42—46.
Nechaev VM, Ivashkin VT, Myagkova LP. 2001. Sindrom korotkoy kishki. Ros zhurn gastroenterol, gepatol, koloproktol. 11;5: 11—18.
Zhvaniya FF, Lazareva TS, Obryadov VP i dr. 2008. Osobennosti nutritivnoy podderzhki rebenka rannego vozrasta s sindromom korotkoy kishki priobretennogo haraktera. Vestn pediatrich farmakol i nutritsiol. 5;4: 74—77.
Parfenov AI. 2002. Enterologiya. M: 724.
Hem A, Kormak D. 1983. Gistologiya. T. 4. M, Mir: 137—152.
Hiroi K, Goto Y, Ishikawa J, Kida K. 1995. A case of beriberi accompanying short bowel. Acta Paediat. Jpn. 37;1: 84—87.
Lukish J, Schwartz MZ, Rushin JM, Riordan GP. 1997. A comparison of the effect of growth factors on intestinal function and structure in short bowel syndrome. J Pediat Surg. 32;11: 1652—1655.
Byrne TA, Persinger RL, Young LS et al. 1995. A new treatment for patients with short_bowel syndrome. Growth hormone, glutamine, and a modified diet. Ann Surg. 222;3: 243—254.
Caldarini MI, Pons S, D'Agostino et al. 1996. Abnormal fecal flora in a patient with short bowel syndrome. An in vitro study on effect of pH on D-lactic acid production. Dig Dis Sci. 41;8: 1649—1652.
Avitzur B. 2010. Intestine transplantation in children: update 2010. Ped Clin N Am. 57: 415—431. http://dx.doi.org/10.1016/j.pcl.2010.01.019; PMid:20371045
Bianchi A. 1999. Experience with longitudinal intestinal lengthening and tailoring. Eur J Ped Surg. 9(4): 256—259.
Bianchi A. 1997. Longitudinal intestinal lengthening and tailoring: results in 20 children. JR Soc Med. 90(8): 429—432.
Bustos D, Pons S, Pernas J et al. 1994. Fecal lactate and short bowel syndrome. Dig Dis Sci. 39;11: 2315—2319.
Fiore NF, Ledniczky G, Liu Q et al. 1998. Comparison of interleukin-11 and epidermal growth factor on residual small intestine after massive small bowel resection. J Pediatr Surg. 33;1: 24—29.
Frongia G, Kessler M, Weih S, Nickkholgh A et al. 2013. Comparison of LILT and STEP procedures in children with short bowel syndrome — a systematic review of other literatute. J Ped Surg. 48(8): 1794—1805. http://dx.doi.org/10.1016/j.jpedsurg.2013.05.018; PMid:23932625
Thompson JS, Rochling FA, Weseman RA, Mercer DF. 2011. Current Management of the Short Bowel Syndrome. Surg Clin N Am. 91: 493—510. http://dx.doi.org/10.1016/j.suc.2011.02.006; PMid:21621693
Johnson CP, Sarna SK, Zhu YR et al. 1996. Delayed gastroduodenal emptying is an important mechanism for control of intestinal transit in short-gut syndrome. Amer J Surg. 171;1: 90—95.
Dhodapkar KM, Henry NK. 1996. Leuconostoc bakteremia in an infant with short-gut syndrome: case report and literature review. Mayo Clin Proc. 71;12: 1171—1174.
Ohkohchi N, Andoh T, Izumi U et al. 1997. Disorder of bile acid metabolism in children with short bowel syndrome. J Gastroenterol. 32;4: 472—479.
Bongaerts G, Tolboom J, Naber T et al. 1995. D-lactic acidemia and aciduria in pediatric and adult patients with short bowel syndrome. Clin Chem. 41;1: 107—110.
King DR, Anvari M, Jamieson GG, King JM. 1996. Does the colon adopt small bowel features in a small bowel environment? Aust N Z J Surg. 66;8: 543—546.
Dunn JC. 2008. Is the tissue-engineered intestine clinically viable? Nat Clin Pract Gastroent Hepatology. 5: 366—367. http://dx.doi.org/10.1038/ncpgasthep1151; PMid:18493236
Scolapio JS, Camilleri M, Fleming CR et al. 1997. Effect of growth hormone, glutamine, and diet on adaptation in short-bowel syndrome: a randomized, controlled study (see comments). Gastroenterology. 113;4: 1074—1081.
Braugerie L, Carbonnel F, Hecketsweiler B et al. 1997. Effects of an isotonic oral rehydration solution, enriched with glutamine, on fluid and sodium absorption in patients with a short-bowel. Aliment Pharmacol Ther. 11;4: 741—746.
Wilmore DW, Lacey JM, Soultanakis RP et al. 1997. Factors predicting a successful outcome after pharmacologic bowel compensation. Ann Surg. 226;3: 288—292.
Figueroa Colon R. Superior vena cava occlusion syndrome in a patient receiving.
Garnett GM, Kang KH, Jaksic T, Woo RK et al. 2014. First STEPs: serial transverse enteorplasty as a primary procedure in neonates with congenital short bowel. J Ped Surg. 49(1): 104—107. http://dx.doi.org/10.1016/j.jpedsurg.2013.09.037; PMid:24439591
Nigthtingale JM, Kamm MA, van der Sijp JR et al. 1996. Gastrointestinal hormones in short bowel syndrome. Peptide YY may be the «colonic brake» to gastric empting. Gut. 39;2: 267-272.
Godoy BZ, Faintuch J, Marin ML. 2013. Off label pharmacological therapy in patients with short bowel syndrome. Eur Pev Med Pharmacol Sci. 17: 3285—3295.
Hollwarth ME. 2003. Short bowel syndrome and surgical techniques for the baby with short intestines. Newborn surgery. Puri P (ed). Arnold, London: 569—576.
Hollwarth ME. 1999. Short bowel syndrome: pathophysiology and clinical aspects. Pathophysiology. 6: 1—19.
Kaufman SS, Loseke CA, Lupo JV et al. 1997. Influence of bacterial overgrowth and intestinal inflammation on duration of parenteral nutrition in children with short bowel syndrome. J Pediat. 131;3: 356—361.
Sukhotnik I, Silpovich L, Shiloni E, Mor-Vaknin N, Coran A. 2002. Intestinal adaptation in short bowel syndrome in infants and children: a collective review. Pediatr Surg Int. 18: 258-263. http://dx.doi.org/10.1007/s003830100695; PMid:12021975
King B, Carison G, Khalil BA, Morabito A. 2013. Intestinal bowel lengthening in children with short bowel syndrome: systematic review of the Bianchi and STEP procedures. World J Surg. 37(3): 694—704. http://dx.doi.org/10.1007/s00268-012-1879-3; PMid:23232820
Jeppesen PB, Perkiewicz M, Messing B. 2012. Teduglutide reduces need for parenteral support among patients with short bowel syndrome with intestinal failure. Gastroent. 43: 1473-1481. http://dx.doi.org/10.1053/j.gastro.2012.09.007; PMid:22982184
Kaneko T, Bondo Y, Kurihara H. 1997. Fecal microflora in a patient with short-bowel syndrome and identification of dominant lactobacilli. J Clin Microbiol. 35;12: 1381—1385.
Kaufman A. 2001. Indications for pediatric intestinal transplantation : a position paper of the American Society of transplantation. Ped Transpl. 5: 80—87. http://dx.doi.org/10.1034/j.1399-3046.2001.005002080.x
Koffeman GI, van Gemert WG, George EK. 2003. Classification, epidemiology and aetiology. Best practice and research. Clin Gastroent. 17: 879—893.
Lyer KR. 2014. Surgical management of short bowel syndrome. JPEN J Parenter Enteral Nutr. 38;Suppl 1: 53—59. http://dx.doi.org/10.1177/0148607114529446; PMid:24668996
McMahon MJ, Kuller JA, Chescheir NC. 1996. Prenatal ultrasonographic findings associated with short bowel syndrome in two fetuses with gastroschisis. Obstet Gynecol. 88;4; pt 2: 676-678.
Hausbrandt PA, Ainoedhofer H, Saxena AK, Schalamon J. 2013. Mechanical elongation of the small intestine: evaluation of techniques for optimal screw placement in a rodent model. Biomed Res Int. 2013: 601—701. http://dx.doi.org/10.1155/2013/601701; PMid:23984385 PMCid:PMC3741941
Mayr J, Schober P, Weeissenteiner U, Hollwarth M. 1999. Morbility and mortality of the short bowel syndrome. Eur J Ped Surg. 9: 231—235.
Wales PW, de Silva N, Kim J, Lecce L. 2004. Neonatal short bowel syndrome: population-based estimates of incidence and mortality rates. J Ped Surg. 39(5): 690—695. http://dx.doi.org/10.1016/j.jpedsurg.2004.01.036
O'Keefe P. 2013. Safety and efficacy of Teduglutide after 52 weeks of treatment in patients with short bowel syndrome intestinal failure. Clin Gastroenterol Hepatol. 13: 87—96.
O'Keefe SJ, Jeppesen PB, Gilroy R. 2013. Safety and efficacy of Teduglutide after 52 weeks of treatment in patients with short bowel intestinal failure. Clin Gastroent Hepatology. 11: 815-823. http://dx.doi.org/10.1016/j.cgh.2012.12.029; PMid:23333663
Reinshagen K. 2008. Long-term outcome in patients with short bowel syndrome after LILT. J Ped Gastroenterrol Nutr. 47(5): 573—578. http://dx.doi.org/10.1097/MPG.0b013e31816232e3
Revillon D. 2011. Indications and strategies for intestinal transplantation. J Ped Surg. 46: 280—283. http://dx.doi.org/10.1016/j.jpedsurg.2010.11.002; PMid:21292073
Printz H, Schlenzka R, Requadt P et al. 1997. Small bowel lengthening by mechanical distraction. Digestion. 58;3: 240—248.
Spenser AU, Neaga A, West B. 2005. Pediatric short bowel syndrome: redefining predictors of success. Ann Surg. 242(3): 403—409. http://dx.doi.org/10.1097/01.sla.0000179647.24046.03
Voss A, Melchers WJ, Bijl D et al. 1996. Staphylococcus epidermidis catheter-related infections in a short-bowel patient. Persistence of a single strain over a two-year period. Infect Control Hosp Epidemiol. 17;10: 669—671.
Thompson J. 2012. Current Management of Short Bowel Syndrome. Curr Probl Surg. 49(2): 52— 115. http://dx.doi.org/10.1067/j.cpsurg.2011.10.002; PMid:22244264
Colon RF, Harris PR, Birdsong E et al. 1996. Superior vena cava occlusion syndrome in a patient receiving total parenteral nutrition for short bowel syndrome. J Pediat Surg. 31;7: 912-916.
Liu Q, Du XX, Schindel DT et al. 1996. Trophic effects of interleukin_11 in rats with experimental short bowel syndrome. J Pediat Surg. 31;8: 1047—1050.
Vanderhoof JA, Langnas AN. 1997. Short bowel syndrome in children and adults. Gstroenterol. 113(5): 1767—1778.
Vantini I, Benini L, Bonfante F. 2004. Survival rate and prognostic factors in patients with intestinal failure. Dig Liver Dis. 36: 46—47. http://dx.doi.org/10.1016/j.dld.2003.09.015; PMid:14971815
Weih S, Kessler M, Fonouni H. 2012. Current practice and future perspectives in the treatment of short bowel syndrome in children — a systematic review. Langenbeck's archives of surgery. Deutsche Gesellschaft fur Chirurgie. 397: 1043—1051. http://dx.doi.org/10.1007/s00423-011-0874-8; PMid:22105773
